治疗肾细胞癌：现状与未来方向。

Treatment of renal cell carcinoma: Current status and future directions.

机构信息

Experimental Therapeutics Fellow, Department of Hematology and Medical Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH.

Professor of Medicine, Cleveland Clinic Lerner College of Medicine; and Leader, Genitourinary Program, Glickman Urological and Kidney Institute, Department of Hematology and Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH.

出版信息

CA Cancer J Clin. 2017 Nov;67(6):507-524. doi: 10.3322/caac.21411. Epub 2017 Sep 29.

DOI:10.3322/caac.21411

PMID:28961310

Abstract

Answer questions and earn CME/CNE Over the past 12 years, medical treatment for renal cell carcinoma (RCC) has transitioned from a nonspecific immune approach (in the cytokine era), to targeted therapy against vascular endothelial growth factor (VEGF), and now to novel immunotherapy agents. Multiple agents-including molecules against vascular endothelial growth factor, platelet-derived growth factor, and related receptors; inhibitors of other targets, such as the mammalian target of rapamycin and the MET and AXL tyrosine-protein kinase receptors; and an immune-checkpoint inhibitor-have been approved based on significant activity in patients with advanced RCC. Despite these advances, important questions remain regarding biomarkers of efficacy, patient selection, and the optimal combination and sequencing of agents. The purpose of this review is to summarize present management and future directions in the treatment of metastatic RCC. CA Cancer J Clin 2017;67:507-524. © 2017 American Cancer Society.

摘要

回答问题并获得 CME/CNE 在过去的 12 年中，肾细胞癌（RCC）的治疗已经从非特异性免疫方法（细胞因子时代）转变为针对血管内皮生长因子（VEGF）的靶向治疗，现在又发展到新型免疫治疗药物。多种药物——包括针对血管内皮生长因子、血小板衍生生长因子和相关受体的分子；针对哺乳动物雷帕霉素靶蛋白和 MET 和 AXL 酪氨酸蛋白激酶受体等其他靶点的抑制剂；以及免疫检查点抑制剂——已经基于晚期 RCC 患者的显著活性获得批准。尽管取得了这些进展，但关于疗效的生物标志物、患者选择以及药物的最佳组合和顺序等重要问题仍然存在。本文综述了转移性 RCC 的治疗现状和未来方向。CA Cancer J Clin 2017;67:507-524. © 2017 美国癌症协会。